Jaundice

Question 1

What are the clinical signs of jaundice?

Answer 1

• yellowing of the skin, sclera and mucosa
• serum bilirubin > 50umol/L
• itch
• dark urine
• pale stools

Question 2

What are the 3 different types of jaundice?

Answer 2

• pre hepatic
• intra hepatic
• post hepatic

Question 3

What are the causes of pre-hepatic jaundice?

Answer 3

• excess haeme production i.e. as a result of haemolysis
• Generally -> raised total bilirubin
• normal conjugated bilirubin,
• raised unconjugated bilirubin
• normal LFTs

Question 4

What is a disease that can cause pre-hepatic jaundice?

Answer 4

• increased breakdown of redblood cells

- haemolysis (haemolytic anaemia)

Question 5

What are the causes of intra-hepatic jaundice?

Answer 5

• hepatocellular damage leading to intrahepatic cholestasis
• Generally -> raised total bilirubin
• raised conjugated/unconjugated bilirubin
• Hepatitic LFTs.

Question 6

What is a disease that can cause intra-hepatic jaundice?

Answer 6

• viral hepatitis
• drugs
• alcoholic hepaitis
• cirrhosis

Question 7

What are the causes of post hepatic jaundice?

Answer 7

• obstruction to bile outflow from the liver (leaks into blood)
• Generally-> raised total bilirubin,
• raised conjugated bilirubin
• normal unconjugated bilirubin
• Obstructive LFTs.

Question 8

What diseases may cause post-hepatic jaundice?

Answer 8

• common duct stones

- caricinoma in the bile duct, head of pancreas, ampulla